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Home My WebLink AboutX2022-1594 - PermitsCity of Newport Beach - Building Division c r�s 100 Civic Center Drive, Newport Beach, CA 92660 Permit Counter Phone (949)644-3288 Inspection Requests Phone (949)644-3255 Combination Type - SFP ELEC MECH �crati 111111111111111111111111111111111111111111111111 COMB Permit: X2022-1594 Project No : 1453-2022 Issued Date : 06/06/2022 Inspection Area : 5 PERMIT EXPIRES 180 DAYS AFTER ISSUANCE OR LAST VALID INSPECTION. PROJECTS MUST BE COMPLETED BY OR PERMIT WILL BE INVALID Construction Hours: Monday- Friday 7:00 a.m. to 6:30 p.m. and Saturday from 8:00 a.m. to 6:00 p.m. No work on Sundays or Holidays Job Address: 102 ARCHIPELAGO DR NB Description: DELTA 1 - ADD'L SCOPE- ADD LIGHTS/FAN IN MBATH & EXHAUST FAN IN LAUNDRY Legal Desc.: Owner: MOORE RICK Contractor: BURKHART BROTHERS CONSTR Address: 102 ARCHIPELAGO DR Address: 12 BALBOA COVES NEWPORT COAST CA 92657 NEWPORT BEACH CA 92663 Phone: Phone: 949-375-6725 Applicant: TSAI SPENCER Con State Lic: 905510 Address: 1382 VALENCIA AV STE F Lic Expire: 10/31/2023 TUSTIN CA 92780 Bus Lic: BT30026859 Phone: 949-402-5581 Lic Exp Date: 03/31/2023 Code Edit : 2019 Type of Construction: V-B Occupancy Group: R3/U Added /New sq.ft. Bldg: 0 Added /New sq. ft. Garage: 0 No of Stories: 2 No of Units : 1 Bldg Height: 0 Bldg Sprinklers: Valuation: $1,000.00 Building Permit Fee: $110.00 Plan Check Fee: $0.00 Overtime Plan Ck: $0.00 Investigation Fee: $0.00 Record Management: $0.00 Energy Compliance: $0.00 CA Seismic Safety: $0.00 Disabled Access : $0.00 Hazardous Mat $0.00 Building Green Fee : $1.00 TOTAL FEE: $123.10 Worker's Compensation Insurance Carrier. SECURITY NATIONAL INS Policy No: SWC1373426 Expire: 02/0112023 Building Setbacks Excise Tax: Additional Fee Grading Bonds Fee: Grading PC Consultant Grading Permit Fee: Grading PC Fee: WQ Insp. Fee: Electrical %: Mechanical %: Plumbing %: Rear: / Front: / Left: / Right: / $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.70 $4.40 $0.00 Architect Address: Phone: State Lic: Engineer: Address: Phone: State Lic: Designer: Address: Phone: Special Conditions: Planning Department - Plan check Fee Fair Share SJH Trans In -lieu Housing Fee Public Works Department - Park Dedication : $0.00 PAN Plan Check : $0.00 San Dist : $0.00 NMUSD Fee: $0.00 d Zone : N Fire Department $0.00 Fire Inspection: $0.00 $0.00 Fire Plan Rev $0.00 $0.00 Demolition Fee $0.00 Building Dept Adm $0.00 General Service $0.00 Refund Deposit $0.00 Grading Bond: $0.00 $0.00 $0.00 Plan Check Fee : $0.00 Fee Due at Permit Issuance : $123.10 PROCESSED BY: _ _ - PUBLIC WORKS APPROVAL: ZONING APPROVAL: wee PLAN CHECK BY: GRADING APPROVAL: _ _ APPROVAL TO ISSUE: OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the reason(s) indicated below by the checkmark(s) I have placed next to the applicable item(s) (Section 7031.5, Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for the permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt from licensure and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do L) all of or L ) portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for the projects with a licensed Contractor pursuant to the Contractors' State License Law). ❑ 1 am exempt from licensure under the Contractors' State License Law for the fallowing reason: By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legal) sell a structure that I have built as an owner -builder if it has not been constructed in its entirety by licensed contractors. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site:http://www.ieginfo.ca.gov/calaw.htm1. Signature of Property Owner or Authorized Agent Date LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Sect' n 7000) of Division 3 of the Business and ProkVions C9de, and my license is in full force and effect. License Class License No Da �C /�9_T� Contractor Signature .4#& WORKERS' COMPENSATION DECLARATION WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000(, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for th pe ormance of the work for which this permit is issued. Policy No. have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compel in rance carrier and policy number are: Carrier Policy Number Expiration Date Name of Agent Phone # ❑1 certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and ogre that, if I should become subjgct tot workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Signature of Applicant �Y.6 f 6��yZ DECLARATION REGARDINIS CONSTRUCTION LENDING AGENCY I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name Lender's Address By my signature below, I certify to each of the following: I am the property owner or authorized to act on the property owner's behalf. I have read this application and the information I have provided is correct. I agree to comply with all applicable city and county ordinances and state laws relating to building construction. I authorize representatives of this city or co ty to enter the above -identified property for inspection purposes. C Signature of Property Owner or Authorized A en Print Property Owner's or Authorized Agent's Name = Gei I—L: Date O ACTION DATE BY ACLARATION OF COMPLIANCE WITH CODE OF FEDERAL FOR OFFICE USE ONLY REGULATIONS PART 61 OF TITLE 4C AND AQMD RULE 1403 PERMIT EXPIRED LJ I SUBMITTED ASBESTOS NOTIFICATION TO PERMIT CANCELLED LJEPA PERMIT EXTENDED QMD PERMITFINAL �2-L �A BESTOS NOTIFICATION IS NOTAPPLICABLE TO CERTIFICATE OF PROPOSED DEMOUTI N OCCUPANCY ISSUED SIGNATUR